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Informing Policy. Advancing Health.

Free-Standing ER's: A New Trend in Emergency Care

An emerging trend in emergency care in Colorado is causing some concern about a potential disruption in the system.
Date last upated: January 18, 2014

An emerging trend in emergency care in Colorado is causing some concern about a potential disruption in the system.

Independent free-stranding emergency rooms – different than urgent care centers or emergency departments affiliated with hospitals – are walk-in clinics that provide round-the-clock care for everything from the common cold to heart attacks. However, the charge for the visit is always the same as an emergency room visit – regardless of the urgency of the ailment. Emergency room charges are often four or five times higher than that of a regular visit.

Additionally, these free-standing emergency centers do not bill for Medicaid or Medicare because they are not part of a hospital system. Because of that, they aren’t bound by the federal requirement to accept public insurance.

This combination of high prices and the inability to bill for public insurance has some worried that these free-standing emergency rooms are taking advantage of people who can’t get an appointment as soon as needed at their regular doctor or others who don’t understand the difference between these emergency rooms and urgent care centers.

The 2013 Colorado Health Access Survey (CHAS) found that 15.0 percent of respondents reported that they were unable to get an appointment at the doctor’s office or clinic as soon as they thought one was needed and 10.1 percent of employed adults said they could not make an appointment because they couldn’t take off from work. In operation at all hours, free-standing emergency rooms serve as a convenient alternative for Coloradans who experience problems accessing health care.

Free-standing emergency room operators and their proponents argue that these centers provide a community benefit by offering an accessible place of care and a solution for those who can’t get health care when they need it.

Though it can’t bill for Medicaid or Medicare, First Choice Emergency Room – a free-standing emergency department based in Texas which operates two facilities in Colorado – reports that about 25 percent of its patients receive treatment free of charge.

Senator Aguilar, a Democrat from Denver, has introduced a bill to regulate independent free-standing emergency rooms by requiring them to be located more than 25 miles from a hospital. If the free-standing emergency room is within 25 miles of a hospital, the bill requires that the center become affiliated with a licensed or certified hospital within two years of the bill’s effective date.  The Colorado Health Institute will track the progress of this bill.